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Biomedical subjects

M Sexton

Publications and source records attributed to M Sexton.

At least 37 records · Page 2Linked to original sources
PubMed1991

Baseline factors associated with smoking cessation and relapse. MRFIT Research Group.

BACKGROUND: Data on smoking cessation and relapse for 6 yers of the Multiple Risk Factor Intervention Trial were evaluated in univariate and multivariate analyses to determine the relationship between variables measured at the beginning of the trial and smoking cessation and relapse for special intervention and usual care participants. RESULTS: The variables positively associated with smoking cessation in both the SI and the UC groups included age, education, and past success in quitting; there was a negative association with the number of cigarettes smoked per day. The expectation of quitting was positively associated with cessation in the special intervention group only, while life events, alcohol, and the presence of a wife who smokes were significant predictors of reduced cessation for the usual care group. The special intervention program may have overcome obstacles which interfered with cessation among the usual care participants. Associations with relapse were generally stronger in the usual care group than in the special intervention group. For usual care participants, multivariate analyses showed that education, past success in quitting smoking, alcohol, and life events were associated with relapse rates. For special intervention participants, only alcohol emerged as a significant predictor. Conclusion. The data are relevant in terms of factors that govern smoking cessation and relapse for adult smokers who take part in formal intervention programs and for those who are left to modify their behavior on their own.

Age Factors↗
PubMed1991

Occult herpesvirus folliculitis clinically simulating pseudolymphoma.

Two cases of cutaneous herpesvirus infection are described that clinically masqueraded as pseudolymphoma. Light microscopy demonstrated typical viral changes involving pilosebaceous complexes with sparing of the surface epithelium. Dermal changes consisted of a dense perivascular and perifollicular inflammatory infiltrate. Multinucleated lymphoid cells were found in the dermis in one case and viral inclusions in fibroblasts were present in the other case. Immunoperoxidase stains with antisera to herpes simplex virus types I and II were positive in one case and negative in the other case. Ultrastructural examination demonstrated viral particles consistent with herpesvirus in both cases. Recognition of typical histologicl features of herpesvirus folliculitis will lead to an accurate diagnosis in these types of clinically unsuspected cases.

Adult↗
PubMed1991

Cytomegalovirus diaper dermatitis.

Cytomegalovirus inclusions have been reported in perineal ulcers from immunosuppressed adults. The importance of this finding is unknown. We report the first pediatric case of cutaneous cytomegalovirus infection in an infant with congenital human immunodeficiency virus infection, presenting as a diaper dermatitis. Cytomegalovirus was cultured from the skin biopsy specimen, and characteristic inclusions were seen on hematoxylin-eosin-stained sections. Results of this biopsy specimen analysis prompted further investigation revealing disseminated cytomegalovirus infection, including retinitis. Aggressive pursuit of a pathogen in common conditions such as diaper dermatitis is strongly recommended in immunosuppressed pediatric patients.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Recurrent pigmented melanocytic nevus. A benign lesion, not to be mistaken for malignant melanoma.

Melanocytic nevi that recur after incomplete removal are pigmented lesions that may clinically and pathologically simulate malignant melanoma in situ. Five examples of recurrent pigmented melanocytic nevus, with emphasis on light microscopic and immunohistochemical findings, are reported herein. Prominent HMB-45 staining in these nevi may cause further confusion in differentiating them from malignant melanoma. The differential diagnosis of recurrent pigmented melanocytic nevi is discussed, with particular emphasis on distinguishing these lesions from malignant melanoma. Our immunohistochemical observations indicate that the recurrences most likely develop as a result of proliferation of melanocytes remaining in the epidermis and/or adnexae following incomplete removal. The approach and management of recurrent nevi are also discussed.

Adolescent↗
PubMed1990

Recurrent carcinoma of the vulva after conservative treatment for "microinvasive" disease.

Although the standard therapy of vulvar carcinoma remains radical surgery, this approach is accompanied by significant postoperative morbidity and psychological adjustment. Radical hemi-vulvectomy and ipsilateral superficial groin node dissection are increasingly used for patients with "early" or "microinvasive" disease. Two patients with an "early" vulvar carcinoma were treated conservatively and later developed recurrent disease. Despite further surgery and radiotherapy, both patients eventually died of disease. The case histories are described and the pertinent literature is discussed.

Aged↗
PubMed1990

Histologic pattern analysis of basal cell carcinoma. Study of a series of 1039 consecutive neoplasms.

This study attempts to define histologic patterns in 1039 consecutive cases of basal cell carcinoma and to correlate these patterns with adequacy of margins of surgical excision. Five major histologic patterns were identified: nodular, 218 cases (21%); superficial, 181 cases (17%); micronodular, 151 cases (15%); infiltrative, 77 cases (7%); and morpheic, 11 cases (1%). A mixed pattern (two or more major histologic patterns) was present in 401 cases (38.5%). Our study indicates that nodular and superficial basal cell carcinomas can be completely removed by simple surgical excision in a high percentage of cases (93.6% and 96.4%, respectively) whereas the micronodular, infiltrative, and morpheic basal cell carcinomas have a higher incidence of positive tumor margins (18.6%, 26.5%, and 33.3%, respectively) after excision. Mixed patterns that consisted of combinations of the nodular, micronodular, or infiltrative types exhibited a behavior similar to the pattern that resulted in a greater chance of incomplete surgical removal.

Basal Cell Carcinoma↗
PubMed1990

Cloning and expression of the Pseudomonas aeruginosa exoenzyme S toxin gene.

The gene for exoenzyme S, an ADP-ribosyl transferase, was cloned from Pseudomonas aeruginosa strain DG1 using an oligonucleotide probe based on the partial N-terminal amino acid sequence to screen a library of DG1 SstI fragments inserted into pKT230 in Escherichia coli DH1. A positive clone, designated pPD3, hybridized with the oligonucleotide probe and contained a 15 kb SstI insert. In E. coli minicells pPD3 expressed a single protein of Mr 68,000. This protein was localized primarily in the periplasm in E. coli. A 3.6 kb HindIII-BamHI fragment was subcloned into the vector pT7-4 which contains the promoter from bacteriophage T7 to construct pT7-4HB. In E. coli strains expressing the T7 RNA polymerase on a second plasmid, the Mr 68,000 protein was expressed and shown to react with antibodies to exoenzyme S. No enzymatic activity was detected in cell sonicates or culture supernatants of E. coli (pPD3). Cell sonicates of E. coli (pT7-4HB) however were cytotoxic to HeLa cells and this cytotoxicity was neutralizable with anti-exoenzyme S antiserm. Thus, exoenzyme S expressed in E. coli is toxic but not enzymatically active. When plasmids carrying the exoenzyme S gene were introduced into P. aeruginosa, there was a significant increase in ADP-ribosyl transferase activity, indicating that the plasmid encoded protein is enzymatically active in P. aeruginosa.

ADP Ribose Transferases↗
PubMed1990

Prenatal exposure to tobacco: I. Effects on physical growth at age three.

The height and weight of 714 children whose mothers smoked at the beginning of their pregnancies were assessed at three years of age. The children of women who quit smoking during pregnancy were taller and heavier than those of women who continued to smoke throughout pregnancy. Adjustment for maternal postpartum smoking status reduced the difference in weight, but had little effect on height. The differences in both height and weight at three years of age were greatly reduced when adjusted for size at birth and length of gestation. These results suggest that deficits associated with maternal smoking are not overcome by three years of age and that at least some of the observed anthropometric deficits may be extensions of deficits in fetal growth.

Body Height↗
PubMed1990

Prenatal exposure to tobacco: II. Effects on cognitive functioning at age three.

Three-year-old children, born to women who smoked ten or more cigarettes at the beginning of pregnancy and identified at the time of registration for prenatal care, were assessed by the McCarthy Scales of Children's Abilities and the Minnesota Child Development Inventory. Children whose mothers quit smoking during pregnancy relative to children whose mothers persisted in smoking performed at a statistically significant higher level on the General Cognitive Index of the McCarthy and on each of the three subscales from which the General Cognitive Index is derived. The scores on the Minnesota Child Development Inventory were similar in showing a higher performance in the children of quitters. Statistical adjustment for environmental factors, characteristics of the child, and fetal maturity did not account for the observed differences between children of women who quit smoking and those of women who continued to smoke.

Child Development↗
PubMed1990

Health care costs for employed hypertensives.

Health care insurance claims were used to track costs associated with hypertension for an employed population. Employees were classified as hypertensive (n = 373), high normal (n = 363), or normotensive (n = 2,411) on the basis of hypertension screening done at the worksite. Claims activity was monitored for the three groups during a three-year period, including periods before, during, and after the screening done at the worksite. The average amount claimed per employee was significantly higher for the hypertensives as compared with the normotensives or high normals, even after adjustment for age, race, sex, salary, marital status, and duration of insurance coverage. There was no significant difference in the average amount claimed per employee between high normals and normotensives. The health care costs for hypertensives are estimated to be about 80% more than those for normotensives. Hospital, physicians, and nursing care accounts for about 50 percentage points of this increment while the remaining 30 percentage points derive from drug costs.

Adult↗
PubMed1990

Hairy polyp of the oropharynx. A case report with speculation on nosology.

The hairy polyp of the oronasopharynx is a rare congenital malformation that has been classified as a dermoid, teratoid, teratoma, or hamartoma in the past. A case of oropharyngeal hairy polyp is presented that occurred in a male neonate with severe intermittent respiratory obstruction. The precise nosology of this unusual malformation is discussed, with the speculation that it is classified as a choristoma.

Connective Tissue↗
PubMed1989

The reliability of self-reports of smoking and alcohol consumption by pregnant women.

The reliability of self-reports of prepregnancy smoking and drinking habits was assessed in over 700 pregnant smokers who participated in a randomized clinical trial of smoking cessation intervention. The participants provided self-reports of their prepregnancy smoking and drinking habits prior to the 18th week (test) and again in the eighth month of gestation (retest). About half the subjects gave identical reports of prepregnancy smoking habits at test and retest. Among those who changed their estimates, the changes were usually small. The reliability of reports of prepregnancy alcohol intake was also high. The reliability of reports by the treatment group - which experienced an anti-smoking intervention and extensive contact with study personnel - was very similar to that of the control group.

Adult↗
PubMed1989

Generalized melanosis in occult primary melanoma.

Once encountered, generalized melanosis as a consequence of disseminated melanoma is not easily forgotten. Cases in the literature usually have resulted from primary cutaneous melanoma. A case of generalized melanosis caused by an occult primary melanoma is reported in a patient who originally complained of increased pigmentation. Findings of light microscopic studies of involved skin, pathogenesis of generalized melanosis, and possible sites of origin of the primary neoplasm are discussed.

Adult↗
PubMed1989

Eruptive vellus hair cysts. A follicular cyst of the sebaceous duct (sometimes)

The eruptive vellus hair cyst is an uncommon, yet distinct, clinical and pathological entity that may be acquired in a sporadic or hereditary form. This descriptive term gives no indication of the type of epithelium lining this cyst. A case report of eruptive vellus hair cyst is reported herein in which the epithelial lining differentiated toward the sebaceous duct. We propose that eruptive vellus hair cysts should be more accurately diagnosed by characterizing the type of epithelial lining.

Adult↗
PubMed1988

Dose-response of birth weight to various measures of maternal smoking during pregnancy.

Thus far little is known about the dose-response relationship between birth weight and the amount of maternal smoking during pregnancy. The purpose of this report is to describe the effects of smoking intensity, duration, and timing on birth weight with the use of three measures of exposure: self-reported daily consumption, self-reported cumulative consumption, and salivary thiocyanate. Data were obtained on 867 single live-born infants and their mothers who participated in a randomized anti-smoking intervention trial. Smoking was measured for the women at about 15 weeks gestation and again during the eighth month. Although all indicators of dose, as derived from early or late pregnancy smoking measures, were significantly associated with birth weight, whether or not the mother had quit smoking by the time of the 8th month follow-up was almost as predictive as any dose variable. For women who quit smoking before 30 weeks gestation, neither the duration nor the amount of smoking earlier in pregnancy was an important determinant of birth weight.

Adolescent↗
PubMed1988

Papillary eccrine adenoma. A light microscopic and immunohistochemical study.

The papillary eccrine adenoma is a rare benign sweat gland neoplasm characterized by a potentially locally aggressive clinical course. The light microscopic findings in two cases of this unusual neoplasm are discussed, with emphasis on the differential diagnosis of this tumor from other benign and malignant sweat gland neoplasms. Immunohistochemistry studies directed against various epithelial antigens were also performed. Immunoperoxidase stains positive for carcinoembryonic antigen, S-100 protein, and epithelial membrane antigen strongly support the hypothesis that this unusual neoplasm differentiates toward the eccrine secretory coil.

Antigens↗
PubMed1987

Risk-factor changes in wives with husbands at high risk of coronary heart disease (CHD): the spin-off effect.

This study of 220 wives of participants from four of the 22 clinics in the Multiple Risk Factor Intervention Trial (MRFIT) addresses the question of whether spouses of men exposed to a continuous coronary heart disease (CHD) risk-factor intervention program (SI group) make changes in their own risk status compared to wives of men who did not receive the intervention program (UC group). Total serum cholesterol and low-density lipoprotein (LDL) cholesterol were significantly lower for the SI wives. These differences were found for both hypertensive and normotensive wives, although the magnitudes were much greater for the hypertensive wives. There were also significant differences between the two groups of wives in the food-record rating and in dietary-knowledge scores, indicating that the probable mechanism for the beneficial effect of the intervention with respect to cholesterol levels was the change in the family diet. Although not statistically significant, differences indicating a lower risk for SI wives were found for diastolic blood pressure. There was also a greater mean reduction in cigarettes per day for SI wives who smoked.

Attitude to Health↗